CONGESTIVE myocardial failure is one of the most important problems in clinical medicine. It may result from any form of heart disease. Among myxedema, beriberi, severe anemia, and arteriovenous aneurysm. In this group the principal measures of treatment are directed toward correcting the underlying disorder. The majority of cases, however, are consequent to the more common types of heart disease. In these, treatment is not determined by the etiology of the condition but consists of well established procedures which are applicable in all instances. Intensive research on the pathologic physiology of congestive failure during the past few years has resulted in the adoption of important changes in therapy which in turn have considerably improved the outlook of the individual patient.
Rest. A period of rest in bed is an essential part of the management of every case of congestive heart failure. Levine1 has pointed out that the sudden enforcement of the conventional type of bed rest may have certain harmful effects. These are to be regarded as complications against which suitable precautions must be taken, and the possibility of their occurrence does not detract from the importance of rest itself. In patients with congestive failure, the recumbent position, through the effect of gravity, brings about a shift of edema fluid from the lower to the upper portions of the body. This often results in prompt diminution in the edema of the lower extremities, but, unless proper treatment has been instituted, edema may simultaneously appear or increase over the back, and. . .